<%@ page contentType="text/html;charset=UTF-8" %>
<%@ include file="/WEB-INF/views/include/taglib.jsp" %>

<div class="panel-body">
    <form:form id="inputForm2" data-parsley-validate="" modelAttribute="treatRecordItem" method="post"
               class="form-horizontal">
        <%--<form:hidden path="id"/>--%>
        <%--<form:hidden path="newDept" value="${doctorTempla.billingDept}"/>--%>
        <form:hidden path="applyId"/>
        <div class="form-group">
            <label class="col-sm-2 control-label">主诉：</label>

            <div class="col-sm-10">
                <form:textarea path="zhusu" cssStyle="height: 150px;" id="zhusu" htmlEscape="false" class=" form-control"/>
            </div>
                <%--<div class="complaint-input" contenteditable="true" submit_id="zhusuId">--%>
                <%--${treatRecordItem.zhusu}--%>
                <%--</div>--%>
        </div>
        <div class="form-group">
            <label class="col-sm-2 control-label">现病史：</label>

            <div class="col-sm-10">
                <form:textarea path="xianbingshi" cssStyle="height: 150px;" id="xianbingshi" data-parsley-required="true" htmlEscape="false" class="form-control"/>
            </div>
        </div>
        <div class="form-group">
            <label class="col-sm-2 control-label">个人史：</label>

            <div class="col-sm-10">
                <form:textarea path="gerenshi" cssStyle="height: 150px;"  id="gerenshi" htmlEscape="false" class="form-control"/>
            </div>
        </div>
        <div class="form-group">
            <label class="col-sm-2 control-label">既往史：</label>

            <div class="col-sm-10">
                <form:textarea path="jiwangshi" cssStyle="height: 150px;" id="jiwangshi" htmlEscape="false" class="form-control"/>
            </div>
        </div>
        <div class="form-group">
            <label class="col-sm-2 control-label">婚育史：</label>

            <div class="col-sm-10">
                <form:textarea path="hunyushi" cssStyle="height: 150px;" id="hunyushi" htmlEscape="false" class="form-control"/>
            </div>
        </div>
        <div class="form-group">
            <label class="col-sm-2 control-label">家族史：</label>

            <div class="col-sm-10">
                <form:textarea path="jiazushi" cssStyle="height: 150px;" id="jiazushi" htmlEscape="false" class="form-control"/>
            </div>
        </div>
        <%--<div id="examineDivId" style="padding: 0px">--%>
        <%--<div class="complaint-check">--%>
        <%--<div>检查检验</div>--%>
        <%--</div>--%>
        <%--<div class="animal">T: <form:input path="tiwen" data-parsley-twonum="1" type="text" name="tiwen" value="${treatRecordItem.tiwen}" class="form-input"/> °C</div>--%>
        <%--<div class="animal">B: <form:input  path="maibo" data-parsley-twonum="1" type="text" name="maibo" value="${treatRecordItem.maibo}"  class="form-input"/> 次/分</div>--%>
        <%--<div class="animal">R: <form:input path="huxi"  type="text" name="huxi" value="${treatRecordItem.huxi}" class="form-input"/> 次/分</div>--%>
        <%--<div class="animal"> BP: <form:input path="xueya"  type="text" name="xueya" value="${treatRecordItem.xueya}" class="form-input"/> mmHg</div>--%>
        <%--<div class="complaint">--%>
        <%--<div>体格检查</div>--%>
        <%--</div>--%>
        <%--<form:input path="tigejiancha" type="hidden"  id="tigejianchaId" value="${treatRecordItem.tigejiancha}" />--%>
        <%--<div class="complaint-input" contenteditable="true" submit_id="tigejianchaId">--%>
        <%--${treatRecordItem.tigejiancha}--%>
        <%--</div>--%>
        <%--<div class="complaint">--%>
        <%--<div>专科情况</div>--%>
        <%--</div>--%>
        <%--<form:input path="xiaojiefenxi" type="hidden"  id="xiaojiefenxiId" value="${treatRecordItem.xiaojiefenxi}" />--%>
        <%--<div class="complaint-input" contenteditable="true" submit_id="xiaojiefenxiId">--%>
        <%--${treatRecordItem.xiaojiefenxi}--%>
        <%--</div>--%>
        <%--<div class="complaint">--%>
        <%--<div>辅助检查</div>--%>
        <%--</div>--%>
        <%--<input form:input path="fuzhujiancha"  type="hidden"  id="fuzhujianchaId" value="${treatRecordItem.fuzhujiancha}" />--%>
        <%--<div class="complaint-input" contenteditable="true" submit_id="fuzhujianchaId">--%>
        <%--${treatRecordItem.fuzhujiancha}--%>
        <%--</div>--%>
        <%--</div>--%>
    </form:form>
</div>